Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
On May 11,2011

Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
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Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."

Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
On April 2011

Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.

Dr. Anuradha
On Jan 2020

Important Notice

Original article / research
Year : 2011 | Month : April | Volume : 5 | Issue : 2 | Page : 252 - 253 Full Version

Psoriasis: An oxidative stress condition

Published: April 1, 2011 | DOI:

Dept of Biochemistry SIMS, Shimoga

Correspondence Address :
Dr. Jyothi. R.S. Assistant Professor, Dept of Biochemistry,
Shivamogga Institute of Medocal Sciences Shimoga-577201,
Karnataka, India Email:


Psoriasis is a chronic inflammatory skin disease that has been associated with abnormal lipid metabolism and a high frequency of cardiovascular events. Several studies have attributed the hypertriglyceridaemia and hyperlipoproteinaemia to retinoids, corticosteroids and thiazide diuretics which are used in the treatment of psoriasis. The present study was undertaken to evaluate whether psoriasis per se is associated with an abnormal lipid profile or whether an abnormal lipid profile occurs due to the medications of psoriasis. Efforts were made to find other diseases which were associated with psoriasis.

This study included 20 male and 20 female, moderate to severe psoriatic patients between the age group of 20-50 years. These patients were clinically diagnosed as psoriasis and had not yet received any treatment. These patients were compared with age and sex matched healthy control subjects. We estimated serumlipid profile, Vitamin E, malondialdehyde (MDA), fasting blood sugar and aspartate amino transferase (AST) and alanine amino transferase (ALT) levels in psoriatic patients and in the control subjects by using the “auto analyzer” and spectrophotometric methods. The psoriatic patients presented a significant increase in the serum lipid profile and malondialdehyde levels and a significant decrease in vitamin E levels. They also showed a significant increase in the fasting blood sugar and the AST and ALT levels.

The data which were obtained from the study i.e. increase in serum lipids and malondialdehyde and decrease in Vitamin E levels show an established state of oxidative stress. The increase in fasting blood sugar and AST and ALT levels indicate that psoriasis may be associated with other oxidative conditions like diabetes mellitus and “non specific” liver disease.


psoriasis, oxidants, antioxidants, oxidative stress conditions, cardiovascular events.

Psoriasis is the most common chronic inflammatory skin disease, affecting about 2% of the general population. The prevalence rates in Europe are quoted to be about 1.5%, whereas in U.S.A., the prevalence is estimated to be about 4.6%. In contrast, lower prevalence rates have been observed in east Africans, American blacks, Indians (0.7%) and among the Chinese populations (0.4%) (1). While the causes of this disease are unknown, genetic, metabolic, immune and environmental factors have been proposed (2). The significance of the genetic background becomes evident, with a concordance of approximately 60% in monozygotic twins (1).

Psoriasis is a chronic inflammatory skin disease which is characterized by an increased prevalence of obesity, hypertension, hyperlipoproteinaemia and oxidative stress, leading to occlusive vascular diseases, cardiovascular accidents, arthritis, diabetes and liver diseases (3), (4), (5).

Several studies have attributed obesity, hypertension and hyperlipoproteinaemia to retinoids, corticosteroids and thiazide diuretics, and liver disease to cyclosporine and methotrexate (anti-metabolites) which are used in the treatment of psoriasis (6), (7).

So, the present study was undertaken to evaluate whether psoriasis per se is a metabolic disease with multisystem involvement or whether the multisystem involvement occurs due to the various medications which are used by the psoriatic patients.

Material and Methods

The present study included 20 male and 20 female, moderate to severe psoriatic patients between the age group of 20-50 years, who were attending Chigateri Hospital which is attached to the J. J. M. Medical College, Davangere. These patients were clinically diagnosed as psoriatic, they had not received any treatment and all the factors for secondary hyperlipidaemia were excluded. The patients and the control subjects were explained in detail about the studyand informed consent was taken from them. Approval was taken from the Ethical Committee of J.J.M. Medical College, Davangere, to use human subjects in the research work.

We estimated serum lipid profile, vitamin-E, malondialdehyde, fasting blood sugar, and AST and ALT levels in the patients and the control subjects by using a Hitachi-916 auto analyzer. Vitamin-E and malondialdehyde levels were estimated by spectrophotometric methods also (8),(9).Approximately 5ml of fasting venous blood sample was drawn and centrifuged and serum was used for analysis.

Descriptive data tests were presented as Mean ± SD. The Mann- Whitney test was used for group comparison. For all, a p-value of 0.05 or less was considered for statistical analysis


We found in our study that the psoriatic patients had significantly increased serum lipids, MDA, fasting blood glucose and AST and ALT levels and significantly decreased levels of Vitamin-E as compared to the control subjects. (Table/Fig 1)(Significantly different from control subjects at p<0.05 (Mann- Whitney test)


We found in our study that the psoriatic patients had significantly increased serum lipids, MDA, fasting blood glucose and AST and ALT levels and decreased levels of Vitamin-E as compared to the control subjects, which was in accordance with the findings of other studies (3),(5).

Although there have been extensive studies on the roles of serum lipids, oxidants and antioxidant levels in psoriasis, their importance in the aetiology or in the enhancement of the disease remains controversial. It has been suggested that there is a genetic predisposition for developing the disease and that several conditions may trigger an enhancement of the disease such as infections, skin traumas, oxidant drugs and stress conditions. Psoriasis is also frequently associated with some diseases, namely cardiovascular diseases, diabetes mellitus and rheumatoid arthritis. It is interesting to notice that these commonly associated pathologies are known as “oxidative stress conditions”. Psoriasis as a clinically inflammatory skin disease, may per se impose an oxidative stress condition (5).

Several studies have found that in psoriasis, the fatty acid composition of the plasma and adipose tissue show a number of aberrations. There was a marked increase in the levels of arachidonic, palmitic and palmitoleic acids and a decrease in the levels of linoleic and α-linolenic acids, which were found to be associated with hypertriglyceridaemia and hyperlipoproteinaemia (6),(10).

The pattern of the increased levels of palmitic and palmitoleic acids and decreased levels of linoleic acid has been considered to be an indicator of a relative deficiency of essential FAs, which has been reported in patients at a risk of (10)(11) and suffering from coronary heart disease (12),(13) , diabetes (14) and liver disease (15).

The cause of the decreased levels of linoleic and α-linolenic acids is not clear. A much decreased intake of these FAs in relation to saturated FAs is one possibility. Reduced absorption may also be considered, especially in view of the proposed intestinal mucosal changes in psoriasis (10), (16).

Furthermore, in severe psoriasis, there may also be pronounced losses from the skin, not only of FAs, but also of trace elements that are necessary both for the intestinal absorption of linoleic acid and for the further metabolization of the essential FAs. Thus, in psoriasis, zinc losses are probably high (17) and zinc seems to influence the absorption of linoleic acid (10), (18).

Thus, the data which was obtained from our study suggests that psoriasis is a clinically inflammatory skin disease which may per se impose an oxidative stress condition, which leads to other oxidative stress conditions such as myocardial infarction, diabetes and “non specific” liver disease and that these conditions are not primarily caused due to the medications of psoriasis.


Wolters. M. Diet and psoriasis: experimental data and clinical evidence. Br J Dermatol 2005;153:706-714
Pietrzak A et al. Activity of serum lipase and the diversity of serum lipids. Med Sci Monit 2002;8(1):9-13
Pesesico A, Zanetti P, Padovan S, Bertoli P. et al. Relation between body weight and blood pressure and some metabolic parameters in psoriatic patients. Br J Dermatol 1988;118:191-194
Mcdonald CJ and Calabresi P. Psoriasis and occlusive vascular disease. Br J Dermatol 1978;99:469- 475
Rocha-Pereira P, Santos-Silva A, Rebelo I, Figueiredo A. et al. Dislipidemia and oxidative stress in mild and in severe psoriasis as a risk for cardiovascular disease. Clinica Chemica Acta 2001;303:33- 39
Vahlquist C, Michaelsson G, Vessby B. Serum lipoproteins in middle aged men with psoriasis. Acta Derm Venerol 1987;67:12-15
Seckin D, Tokgozoglu L, Akkaya S. Are lipoprotein profile and lipoprotein(a) levels altered in men with psoriasis? J Am Acad Dermatol 1994;31:3,445-449
Gowenlock AH. Varley,s Practical Biochemistry.6th ed, CBS publishers: 902-903
Dillard, Kunert KJ. The effects of vitamin E, ascorbic acid and mannitol on alloxan-induced lipid peroxidation in rats. Arch Biochem Biophysics 1982;216(1):202-212
Vahlquist C, Berne B, Boberge M, Michaelsson G. et al. The fattyacid spectrum in plasma and adipose tissue in patients with psoriasis . Arch Dermatol Res 1985;278:114-119
Miettinen TA, Maukkarinen V, Huttunen JK, Mattila S. et al. Fatty acid composition of serum lipids predicts myocardial infarction. Br Med J 1982; 285:683-684
Simpson HCR, Barker K, Carter RD, Cassels E. et al. Low dietary intake of linoleic acid predisposes to myocardial infarction. Br Med J 1982;295:683-684
Wood DA, Butler S, Riemersmaa RA, Thomson M. et al. Adipose tissue and platelet fatty acids and coronary heart disease in Scottish men. Lancet 1984;2:117-121
Schrade W, Boehle E, Biegler R, Harmuth E. Fatty acid composition of lipid fractions in diabetic serum. Lancet 1963;1:285-290
Shapiro HA, Trowbridge JO, Lee JC, Maibach, HI. et al. Liver disease in psoriatics- An effect of methotrexate therapy? Arch Dermatol 1974;110:547-548
Shuster S, Watson AI, Marks J. Small intestine in psoriasis. Br Med J 1967;3:458-460
MacMillen EM, Rowe D. Plasma zinc in psoriasis: relation to surface area involvement. Br J Dermatol 1983;108:301-305
Wallidius G, Michaelsson G, Hardell L-I, Aberg H. The effects of diet and zinc treatment on the fatty acid composition of serum lipids and adipose tissue and on serum lipoproteins in two adolescent patients with acrodermatitis enteropathica Am J Clin Nutr 1983;38:512-522

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